Individual provider Active NPI

Wilda Miller Young, LPT

  • Physical Therapist
  • Greensboro, NC
National Provider Identifier
1942250261
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8508 Issued in NC
Practice address
1313 Carolina St
Suite 200
Greensboro, NC 27401-6000
Phone
(336) 275-6380
Fax
(336) 275-6381
NPI assigned
May 10, 2006
Last updated
Nov 14, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8508 NC Primary

Addresses

Primary practice location

1313 Carolina St
Suite 200
Greensboro, NC 27401-6000

Mailing address

2009 Dalton Rd
Greensboro, NC 27408-5825
Phone (336) 574-1506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070924000356 NC Practitioner - Physical Therapist in Private Practice 7214948835 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8508NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Health & Fitness CurrentSince Aug 1, 2023 Accepting new patients
Urology Specialists of the Carolinas PLLC CurrentSince Mar 19, 2007 Accepting new patients
Breakthrough Physical Therapy Physical Therapist Past Accepting new patients
Carolina Diagnostic Corporation Past Accepting new patients
Freedom Healthcare Physical Therapist Past Accepting new patients

Locations

509 N Elam Ave
Fl 2
Greensboro, NC 27403
Phone (336) 274-1114

1006 Broad St
Oriental, NC 28571
Phone (252) 249-1051

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1942250261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 DALTON RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274085825",
            "telephone_number": "336-574-1506",
            "fax_number": "336-370-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 CAROLINA ST",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016000",
            "telephone_number": "336-275-6380",
            "fax_number": "336-275-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "WILDA",
        "middle_name": "MILLER",
        "name_prefix": "Mrs.",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.